Use of withdrawal (coitus interruptus) has consequences for reproductive health, but
few nationally representative studies exist. We (1) examined patterns of withdrawal
among 15- to 24-year-old women and men, and (2) explored withdrawal's associations with sociodemographic, psychological,
and sexual factors.
Using data from the 2006–2010 National Survey of Family Growth, we assessed reports
of any and only withdrawal use at last sexual episode in the last month from 3517 sexually active
15 to 24 year-old women and men at risk of unintended pregnancy. Logistic regression
documented associations with withdrawal.
Fourteen percent of young women and 17% of young men reported any use of withdrawal at last sex; 7% and 6%, respectively, reported only use of withdrawal. Though associated with few sociodemographic factors, withdrawal
was significantly linked with pregnancy- and condom attitudes. In regression models,
compared to those who said they would be upset if they discovered they were pregnant,
young women who said they would be pleased about a pregnancy were 2.2–2.6 times as
likely to have used any/only withdrawal (p<.01). For both women and men, those who
felt that condoms were likely to diminish sexual pleasure were more likely to have
used any/only withdrawal (odds ratio=1.8–2.6, p<.05).
At their last sexual episode, a greater proportion of young adults used withdrawal
in conjunction with other methods than by itself. The psychological and sexual variables
of orientation toward pregnancy and attitudes about condoms and pleasure were more
strongly linked with withdrawal practices than most sociodemographic variables.
Since a substantial minority of young adults use withdrawal, providers may wish to
speak directly to contraceptive clients about this method, though they should distinguish
between only versus any withdrawal use. Practitioners may also be well served by assessing and responding
to pregnancy orientation and pleasure attitudes in contraceptive counseling.